Antibiotics

Antibiotics are secondary metabolites produced by microorganisms (including bacteria, fungi, actinomycetes) or higher plants and animals that have anti-pathogens or other activities during their lives and can interfere with the development of other living cells. Chemical substances. The commonly used antibiotics in clinical practice are extracts from microbial culture fluids and chemically synthesized or semi-synthesized compounds. At present, there are no less than 10,000 natural antibiotics known.

Antibiotics are classified into natural products and synthetic products. The former is produced by microorganisms, and the latter is a partially synthetic product obtained by structural modification of natural antibiotics. In 1981, China’s fourth National Conference on Antibiotics pointed out that in addition to antibacterial agents, antibacterial agents, anti-tumor, anti-virus, anti-protozoal, parasites, and insects have also developed rapidly in recent years. Some antibiotics have the function of inhibiting certain specific enzymes, while others have other biological or physiological activities. In view of the fact that "antibiotics" have long been out of the scope of antibacterial activities, the term "continue to use antibiotics" has not been able to adapt to the further development of the profession and it is not in line with the actual situation. Therefore, the meeting decided to officially change the name of antibiotics to antibiotics.

Before medicines were discovered, people discovered that some microorganisms grew more than others. Colonization has inhibitory effects and this phenomenon is called antibiotics. With the development of science, people finally discovered the nature of antibiotics, and found substances with antibiotic effects from certain microorganisms and called them antibiotics, such as penicillin produced by Penicillium, produced by Streptomyces griseus Streptomycin has a significant antibacterial effect. Therefore, people refer to a class of chemical substances that are produced by certain microorganisms in the course of their lives and that have the effect of inhibiting or killing certain other pathogenic microorganisms as antibiotics. Since some of the antibiotics initially discovered had the effect of killing bacteria, antibiotics were once called antibiotics. However, with the continuous development of antibiotics, anti-virus, anti-chlamydia, anti-mycoplasma, and even anti-tumor antibiotics have also been discovered and used in clinical practice. Obviously known as antibiotics is not appropriate, or called antibiotics more practical. The emergence of antineoplastic antibiotics suggests that the chemical substances produced by microorganisms have the effect of inhibiting or killing certain pathogenic microorganisms as well as inhibiting the proliferation or metabolism of cancer cells. Therefore, modern antibiotics are defined. It should be: Chemicals produced by certain microorganisms, substances that inhibit the proliferation of microorganisms and other cells are called antibiotics. Bacteria "missile" is expected to replace antibiotics The tiny protein “missiles” used by bacteria to fight each other are expected to replace the antibiotics used to treat diseases in the near future. An American institute studying the technology hopes to be able to make breakthroughs in the treatment of common diseases in animals such as pigs and chickens. At the same time, the Institute also found that using this protein "missile" can make a breakthrough in the aseptic packaging and preservation of food. Due to the danger of the human body's blood source reacting to antibiotics, the use of this substance can reduce the risk of medicine and there are no after-uses after use. Abuse of harm It can be said that human discovery and application of antibiotics is a great revolution for mankind. Since then, mankind has had a big weapon that can fight with death, because the first killer of human death is a bacterial infection. The clinical application of antibiotics is strict. Definition. At present, our clinical doctors, especially the doctors in primary care units, are particularly serious about the use of antibiotics in clinical work. After the holidays, I went with my family to a rural hometown and, by the way, visited some health and medical units in the counties and townships - health clinics and health centers. The result was really surprising for the status of antibiotics application. In some township health centers Everyone who has a cold often has to "hang the water" - static antibiotics. People often don't pity their money after a cold, especially during the holidays. They all want to be early. In a clinic, a young person The doctor told an old man and said: "Uncle, you have a cold. I will first give you some penicillin. Just point it. Don't use too good drugs, such as cephalosporin. In the future, if you have a serious illness, you'll have to use good medicines..." The result was the old man's grateful saying, "Good." At the same time, there are even more people who take their own antibiotics after a cold, think that antibiotics are all-purpose, and even use antibiotics to prevent disease. Of course, counterproductive. Especially worrying about eating out and eating unclean and taking antibiotics will lead to more serious consequences. Image of this kind of person is using his own body to cultivate “super-resistant bacteria”, until he really gets sick, and antibiotics have no matter Used, and, wait until the doctor found that patients abuse their own antibiotics, they are often unable to return to heaven. I know more about the current situation of clinical abuse of antibiotics. Although this kind of situation seems to be like doctors regardless of illness, the situation of casual use of antibiotics everywhere at the grassroots level, from the attitude and warm and thoughtful service, I can definitely exclude them It is for the sake of certain economic interests to entrap patients. Nowadays, many people use antibiotics for all colds. Although antibiotics are resistant to bacteria and certain microorganisms, they are not anti-viruses. Most of the colds are viral infections, and random use will only increase their side effects and make the body produce drug resistance. However, if blood tests are performed and a bacterial infection is detected, it is necessary to use antibiotics while using antiviral drugs such as ribavirin. Moreover, the psychological effect of using antibiotics is also good for facial expressions, but considering side effects, I do not support this method. Any use of antibiotics that are overtime, excessive, inaccurate or not strictly regulated is an abuse of antibiotics. When people treat diseases, they apply antibiotics and they also exercise resistance to bacteria. When these bacteria and microorganisms are re-infected to other patients, they have a certain resistance to the antibiotics they used, and they spread it repeatedly. At some point, he eventually became less sensitive to the antibiotic. That is to say, people's indiscriminate use of antibiotics will eventually lead people to be resistant to those resistant bacteria and microorganisms. At that time, it will be human sorrow. Although the newly discovered types of antibiotics have gradually increased, But when there is always a time when it can't catch up with the abuse -- when the King Kong and the microbes are trained by human antibiotics. The misuse of antibiotics can lead to dysbacteriosis. Normal human bodies often contain a certain amount of normal flora. They are a good bacteria for people's normal life activities, such as: in people's mouths, intestines, skin... Both of them contain a certain number of beneficial bacteria that normal human life activities, they participate in the normal metabolism of the human body. At the same time, in the human body, as long as the presence of these beneficial bacteria, other harmful bacteria are not easy Survival in these places. An inappropriate analogy is that, as in some lands, there are already a certain number of "humans". Other "humans" are very difficult to survive in this place. People are simultaneously using antibiotics. Antibiotics are not able to identify beneficial or harmful bacteria to humans. As if they were eradicating the local "bandits," they were also killed along with the common people. As a result, the normal flora of the human body was also killed. Other harmful bacteria will reproduce here, resulting in a "secondary infection", which often leads to the use of other antibiotics ineffective, and the mortality rate is high. It is difficult to tolerate that some current pharmaceutical advertisements often mislead people who do not understand medical treatment to abuse antibiotics. For example, we often see advertisements-"Shen Yan's treatment of colds". This is an advertisement that misleads people. Also known as roxithromycin, it is a macrolide drug. It is an out-and-out antibiotic. He does not treat the early symptoms caused by a cold at all. The cause of a cold is mainly a virus. Only a few are caused by bacteria. At present, there are no drugs for humans that can kill the virus in the human body accurately and effectively. The cold is ultimately dependent on the body's own immunity. Only the cold with bacterial infection can apply antibiotics. This example is There are also social reasons for the abuse of antibiotics. Antibiotics are like a double-edged sword. They are scientific and reasonable. They can be used for the benefit of mankind. Inadvertently endanger human health. We live every day in the environment where humans abuse antibiotics, and even the large amount of meat we eat in recent years. In products and aquatic products, it is said that antibiotics are often used. How terrible it is. For example, I know that there are many specialized poultry farmers who use illegal channels to obtain large quantities of antibiotics and hormones that they hope to destroy from hospitals and pharmaceutical companies. Drugs are routinely disassembled and poured in a pot every day, and they are thrown into groups of broiler houses. As a result, some chickens can feed on several tablets. A large number of antibiotics and hormone drugs make chickens in just 34 As soon as I knew it, I would never dare to eat the white pheasants that I sold in the market. Because I think those meat foods contain a lot of penicillin and dexamethasone. . Antibiotic abuse and DNA contamination After the introduction of penicillin, antibiotics became a magical weapon for humans to overcome the germs. However, people soon discovered that although new antibiotics are emerging in an endless stream, there are more and more antibiotic-resistant bacteria, and the spread of drug-resistant bacteria is worrying. In 2003, a study on oral hygiene of children in kindergartens found that about 15% of children’s oral bacteria were resistant to bacteria, and 97% of children had bacteria resistant to 4 to 6 antibiotics in their mouths, although these children had previously No antibiotics have been used for 3 months. In a sense, modern medicine is paying the price for its success. The widespread use of antibiotics strongly inhibits ordinary bacteria, objectively reduces the competition in the microbial world, and thus promotes the growth of drug-resistant bacteria. The rapid increase in the number and type of bacterial drug resistance genes cannot be explained by random mutations in organisms. Bacteria exchange genes not only within the same species, but also between different species, and can even obtain genes from the same type of dead DNA that has died. In fact, every known pathogen has been more or less Obtained drug resistance genes. The researchers' analysis of a vancomycin-resistant enterococci showed that more than a quarter of the genes in the genome, including all antibiotic resistance genes, were foreign. Acinetobacter baumannii, which is resistant to multiple antibiotics, also acquired most of the drug resistance genes in exchange genes with other strains. Researchers are combing the DNA of soil microbes such as Streptomyces and they have tested resistance to multiple antibiotics for each of the nearly 500 Streptomyces strains. As a result, each type of Streptomyces can tolerate seven or eight antibiotics on average, and many can endure fourteen species. For the 21 antibiotics used in the trial, including two entirely new synthetic antibiotics, telithromycin and linezolid, the researchers found resistance genes in Streptomyces. The study found that these drug resistance genes are slightly different from the drug resistance genes in pathogens. There is evidence that drug resistance genes have undergone many transfers during their journey from soil to critically ill patients. The World Health Organization (WHO) called for the prevention of the abuse of antibiotics that led to the development of resistance to bacteria. From January 2006, the European Union’s military has completely banned the use of antibiotics as a growth promoter. According to the Chest magazine of the American College of Chest Physicians, a study conducted by the University of Manitoba in Canada and McGill University in Montreal revealed that the use of antibiotics in infants within the age of one year may increase significantly before age seven. Have the risk of asthma. The study concluded that children who had received antibiotics for non-respiratory infections within one year of age were twice as likely to have asthma at the age of seven as those who had not received antibiotics within one year of age. The greater the number of treatments received, the greater the risk of asthma. Drug classification has anti-pathogens produced by bacteria, mold, or other microorganisms during life. Or other active substances. Since 1943, penicillin has been used clinically, and the number of antibiotics has reached several thousand. There are also hundreds of commonly used clinically. It is mainly extracted from the broth of microorganisms or manufactured by synthetic or semi-synthetic methods. Its classification is as follows: (i) β-Lactams: The molecular structures of penicillins and cephalosporins contain β-lactam rings. In recent years, there have been major developments such as thienamycins, monobactams, β-lactammade inhibitors, and methoxypeniciuins. (B) Aminoglycosides: including streptomycin, gentamycin, kanamycin, tobramycin, amikacin, neomycin, ribomycin, mininormycin, and aspartame Etc. (c) Tetracyclines: including tetracycline, oxytetracycline, chlortetracycline, and doxycycline. (d) Chloramphenicol: including chloramphenicol and thiamphenicol. (5) Macrolide lipids: Clinically commonly used are erythromycin, leucomycin, erythromycin, erythromycin, acetylspiramycin, midamycin, josamycin, and azithromycin. (6) Other antibiotics that act on G+ bacteria, such as lincomycin, clindamycin, vancomycin, bacitracin, etc. (7) Other antibiotics that act on G-bacteria, such as polymyxins, fosfomycin, vitamomycin, cycloserine, and rifampicin. (h) Antifungal antibiotics such as griseofulvin. (9) Antitumor antibiotics: such as mitomycin, actinomycin D, bleomycin, adriamycin, etc. (x) Antibiotics with immunosuppressive effects such as cyclosporine. Streptomycin It is an antibiotic extracted from Streptomyces (Gray Streptomyces) culture fluid. The streptomycin sulfate is a white or slightly yellow powder or crystal that is easily soluble in water and relatively stable. It has significant antibacterial and bactericidal effects on certain bacilli, especially Mycobacterium tuberculosis. Streptomycin is mainly used for the treatment of tuberculosis, plague, whooping cough, bacterial dysentery and urinary tract infections. Chlortetracycline Also known as "chlorotetracycline", it is an antibiotic that is extracted from the broth of the gold mold (Auricularia auricula). The chlortetracycline hydrochloride is a golden yellow crystal, bitter, soluble in water. Aureomycin is mainly used for the treatment of bacterial infections that produce resistance to penicillin, as well as typhus, atypical pneumonia, trachoma, amebic dysentery and other diseases. Schistosomidin Also known as "Potassium Dioscorea" and "Bragos", it is an antibiotic extracted from actinomycetes culture fluid and used to control rice blast, rice leaf spot, rice sclerotinia and so on. However, plants such as tomato, tobacco, eggplant, mulberry, and beans are more sensitive to muslin and cannot be used. There are several types of sites for known antibiotics: (1) Inhibition of cell wall formation, such as penicillin, mainly inhibits the synthesis of peptidoglycan in the cell wall. The main role of polyoxophosphorin (a well-functioning fungicide) is to inhibit the synthesis of chitin in the cell wall of the true cell. (2) affect the function of cell membranes, such as multi-mucillus at least combined with cells, acting on lipopolysaccharides, lipoproteins, so the gram-negative bacteria have a strong bactericidal effect, nystatin and fungal cell membrane steroid binding, Destruction of the structure of the cell membrane. (3) Interfering with the synthesis of proteins, there are many antibiotics that inhibit the growth of microorganisms by inhibiting protein biosynthesis, such as kanamycin and streptomycin. (4) Blocking the synthesis of nucleic acids, mainly by inhibiting the synthesis of DNA or RNA, inhibits the growth of microorganisms, such as rifamycin, bleomycin, and the like. There are four main mechanisms for bactericidal antibiotic bactericidal effect of drugs Inhibition of bacterial cell wall synthesis: Inhibition of cell wall synthesis leads to bacterial cell rupture and death. Antibiotics that act in this manner include penicillins and cephalosporins. Mammalian cells have no cell walls and are not affected by these drugs. Interaction with the cell membrane: Some antibiotics interact with the cell membrane of the cell and affect the permeability of the membrane, which has a fatal effect on the cell. Antibiotics that act in this way are polymyxins and bacilli. Interfering with protein synthesis: Interfering with the synthesis of proteins means that the enzymes necessary for cell survival cannot be synthesized. Antibiotics that interfere with protein synthesis include famycins (actinomycins), aminoglycosides, tetracyclines, and chloramphenicol. Suppression of transcription and replication of nucleic acids: The function of inhibiting nucleic acids prevents cell division and/or synthesis of the desired enzyme. Antibiotics that act in this way include nalidixic acid and dichloroacridine. The resistance of antibiotic-resistant bacteria to antibiotics (including antibacterial drugs) mainly has 5 mechanisms 1. Decompose or inactivate antibiotics: Bacteria produce one or more hydrolytic enzymes or inactivating enzymes to hydrolyze or modify the antibiotics that enter the bacteria and lose their biological activity. For example, β-lactamase produced by bacteria can decompose antibiotics containing β-lactam ring; and the passivation enzymes (phosphotransferase, nucleic acid transfer enzyme, acetyltransferase) produced by bacteria lose the antibacterial activity of aminoglycoside antibiotics. 2. Change the target of antibacterial drugs: As a result of mutations in the bacteria themselves or in the modification of the enzymes produced by the bacteria, the structure of the targets of the antibiotics (nucleic acids or nuclear proteins) changes so that the antibacterial drugs do not work. For example, methicillin-resistant Staphylococcus aureus is modified by the modification of the protein binding site of penicillin to render the bacteria insensitive to the drug. 3. Changes in cell characteristics: Changes in the permeability of the bacterial cell membrane or changes in other properties prevent the antimicrobial agent from entering the cell. 4. The bacteria produces a drug pump that pumps the antibiotic into the cell: An active mode of transport produced by bacteria, pumps the drug that enters the cell out of the cell. 5. Change the metabolic pathway: For example, sulfonamides and p-aminotoluene acid (PABA) compete for dihydroabietic acid synthase and produce bacteriostatic action. Another example is that S. aureus has increased its PABA production after repeated exposure to sulfa drugs. Reached 20 to 100 times the yield of the original susceptible strain, the latter competed with sulfa drugs for dihydroabietic acid synthetase, making the effect of sulfa drugs drop or even disappear. The following basic principles must be taken into consideration when using antibiotics for clinical use of drugs: (1) Strictly grasping the indications Everyone can be used as little as possible, and in addition to considering the antibacterial effects of antibiotics, it is also necessary to grasp the adverse reactions of drugs and the relationship between the internal processes and efficacy. (2) Those with unexplained fever are not advised to use antibiotics. In addition to critically ill and highly suspected bacterial infections, those whose fever is unclear should not use antibiotics, because the use of antibiotics often makes it difficult for pathogenic microorganisms to be detected, and the clinical manifestations are not typical. Affect clinical diagnosis and delay treatment. (C) Viral or estimated viral infections No antibiotics are not effective against a variety of viral infections. It is harmless to give antibiotics to patients with measles, mumps, colds, and flu. More than 90% of angina and upper respiratory tract infections are caused by viruses. Therefore, in addition to being definitely a bacterial infection, antibiotics are generally not used. (d) skin and mucous membrane local as possible to avoid the application of antibiotics due to prone to allergic reactions and easy to produce resistant bacteria. Therefore, in addition to the topical antibiotics such as neomycin and Bacitracin, the local application of other antibiotics, particularly penicillin G, is avoided as much as possible. The application of antibiotics to the mucous membranes of the eye and the burn of the skin is a matter of choosing the right period of time and the appropriate dose. (e) Strictly control the scope of preventive antibiotics. Preventative treatment may be used in the following cases: 1. Patients with rheumatic fever regularly use penicillin G to eradicate pharyngeal hemolytic streptococci and prevent the recurrence of rheumatic fever. 2. Rheumatoid or congenital heart disease before and after surgery with penicillin G or other appropriate antibiotics to prevent the occurrence of subacute bacterial endocarditis. 3. When the lesion is removed, appropriate antibiotics are selected depending on the sensitivity of the pathogen. 4. After war wounds or compound trauma, penicillin G or a tetracycline family are used to prevent gas gangrene. 5. Kanamycin, neomycin, etc. are used for bowel preparation before colon surgery. 6. After severe burns, penicillin G was applied before skin grafting to eliminate hemolytic streptococcal infection. Or use the appropriate antibiotics to prevent the occurrence of sepsis according to the bacterial and susceptibility results of the wound. 7. Patients with chronic bronchitis and bronchiectasis can use prophylactic antibiotics in the winter (limited to outpatients). 8. The use of antibiotics 1 day before surgery can prevent infection. (6) Emphasis on the importance of comprehensive treatment In the course of the application of antibiotics in the treatment of infectious diseases, it is necessary to fully recognize the importance of the human defense mechanism and not to rely too much on the efficacy of antibiotics while ignoring the factors in the human body when human immunoglobulins are present. Insufficient quality and quantity, low cellular immune function, or insufficient phagocyte performance and quality, antibiotic treatment is difficult to be effective. Therefore, in the application of antibiotics should be the same as the best efforts to improve the patient's general condition; take a variety of comprehensive measures to improve the body's low resistance, such as reducing the patient's excessive body temperature; attention to diet and rest; correct water, electrolytes and Base balance disorders; improved microcirculation; blood volume supplementation; and treatment of primary diseases and focal lesions. Continuous use of antibiotics should not exceed one week If you use antibiotics in excess, it is easy to cause fungal vaginitis in women. Director of the Department of Obstetrics and Gynecology of the Armed Police General Hospital, Director Wang Lina explained that the occurrence of vaginitis is not entirely due to poor personal hygiene. Excessive use of antibiotics may also lead to genital inflammation. In fact, one of the side effects of antibiotics is to destroy the balance of bacterial communities in the body. A previous survey in the United States showed that with a strong antibiotic in excess of one week, nearly half of the women in the women developed fungal infections. In fact, the vagina of healthy women is inherently “self-cleansing”. There is a lactobacillus in the vagina that can maintain moderately acidic conditions in the vagina. This way, it is customary to grow molds in an alkaline environment. Under normal circumstances, It cannot survive here. However, the long-term use of antibiotics will inhibit the lactic acid bacteria in the vagina, lose antagonism on the mold, disrupt the natural balance of the vagina, change the vaginal microenvironment, so that the rapid proliferation of bacterial pathogens, leading to the occurrence of fungal vaginitis. At present, some women are blindly pursuing higher grades in the use of drugs. They often believe in the import of antibiotics and cause small flu to cause severe fungal and fungal infections. In this regard, Director Wang reminded the majority of female friends, we must avoid long-term, large-scale use of antibiotics, especially the use of broad-spectrum antibiotics should be less, if according to the condition must use antibiotics, it is recommended continuous use should not exceed one week. In addition, once infected with vaginitis, must go to a regular large hospital for treatment, under normal circumstances, according to the doctor's instructions, adhere to a reasonable use of drugs, the condition will soon turn for the better. [1] Misdiagnosis of drugs At present, most gynecological drugs on the market still contain metronidazole and clotrimazole antibiotics. The direct consequence of excessive use of these drugs is to make the bacteria resistant and disrupt the constraining relationship between vaginal flora, leading to fungi Prosperous and prosperous, women with inflammation will prolong the treatment cycle and increase the dose of medicines. The disease will not be treated effectively. Adverse reactions Drug-induced reactions that are not related to the purpose of the drug are called adverse reactions. It includes: side effects, toxic reactions, after-effects, allergic reactions, teratogenicity, carcinogenesis, mutagenesis and so on. Side effects are intrinsic to the drug, and the normal amount appears to be mild. Toxicity refers to drug-induced physiological and biochemical abnormalities and structural pathological changes, and the severity increases with increasing dose or prolonged course of treatment. The toxicity of antibiotics is more common in clinics, such as timely withdrawal can be alleviated and restored, but it can also cause serious consequences. There are mainly the following aspects: 1 neurotoxic reaction; aminoglycosides damage the eighth on the cranial nerves, causing tinnitus, dizziness, deafness; large doses of penicillin G or semi-synthetic penicillin or cause neuromuscular blockade, manifested as respiratory depression or even respiratory arrest. Chloramphenicol and cycloserine cause psychotic reactions. 2 hematopoietic system toxicity; chloramphenicol can cause anemia aplastic anemia; chloramphenicol, ampicillin, streptomycin, novobiocin, etc. can sometimes cause agranulocytosis. Gentamicin, kanamycin, and cephalosporin IV, V, and VI cause leukopenia, erythrocytes or white blood cells that cause cephalosporins, decreased platelets, and increased eosinophils. 3 Liver and nephrotoxicity: Tobramycin can cause elevated transaminase, most of cephalosporins can cause transaminase, alkaline phosphatase I and II, polymyxins, aminoglycosides and sulfa drugs. Can cause renal tubular damage. 4 Gastrointestinal reactions: After oral antibiotics can cause stomach discomfort, such as nausea, vomiting, abdominal fullness and loss of appetite. Tetracyclines are particularly marked by chlortetracycline, doxycycline, and dimethocycline. In the macrolipids, erythromycin is the heaviest, and medicamycin and spiramycin are lighter. Tetracyclines and rifampicin can cause gastric ulcers. 5 Antibiotics can cause dysbacteriosis, causing vitamin B and K deficiency; it can also cause secondary infections such as pseudomembranous colitis, acute hemorrhagic enteritis, and Candida infections. Pseudomembranous colitis caused by lincomycin and clindamycin was the most common, followed by cephalosporin IV and V. Acute hemorrhagic colitis is mainly caused by semi-synthetic penicillin, with the greatest chance of being caused by ampicillin. In addition, long-term oral high-dose neomycin and the application of kanamycin cause intestinal degenerative changes, resulting in malabsorption syndrome, so that the baby diarrhea and long-term weight does not increase, should be pre-emphasis. A few people use an antibiotic to cause anal itching and perianal erosion that can disappear after stopping the drug. 6 Allergic reactions to antibiotics are generally divided into anaphylactic shock, serum-type reactions, drug fever, rash, angioneurotic edema, and allergic myocardial damage. 7 Antibiotic sequelae effect refers to the biological effects after drug withdrawal, such as permanent deafness caused by chain toxins. Many chemotherapeutic drugs can cause "triple" effects. Rifampicin has a teratogenic rate of 4.3%, and chloramphenicol, griseofulvin and certain antitumor antibiotics have mutagenic and carcinogenic effects. Common drugs [2] Name alias Penicillin G benzyl penicillin; penicillin Oxacillin sodium; oxacillin sodium; oxacillin; oxacillin sodium; Xinqing II; neopenicillin II O-chloropenicillin sodium o-chlorobenzisoxazole penicillin sodium o-chloroxicillin chlorzoacillin chlorzocillin cloxacillin Ampicillin Ambcillin; ammonia bisulfite; ampicillin; ampicillin; ampicillin; Amoxycillin Amoxicillin; Amoxian; Qianbilin Oxopiprazin penicillin sodium piperacillin sodium; piperacillin sodium Procaine penicillin G benzyl penicillin procaine; Pu Qing; penicillin suspension Compound benzathine penicillin triple-effect penicillin Ethacillin sodium Xinqing III; Neopenicillin III Dichloropenicillin Sodium dichlorobenzisoxazole Penicillin sodium; Dicloxacillin sodium; Dichlorothiazide; Dicloxacillin Flucloxacillin sodium Sodium fluoxetazole Isoxazole penicillin sodium; Fluocloline; Fluclipromycin sodium; Flucloxacillin; Fluoxacin Azacycloprine penicillin Ampicillin oxime ester Ampicillin carbon ester ampicillin methyl amyl ester; ampicillin carbonate diester Methyl ampicillin sodium Ampicillin sodium amizocillin sodium; amizocillin; Bailuo Xian; Baimeng Xian; compound Abi Xilin; Lin Biqing Ampicillin tobestillin; Bevacizin; Beziucillin; Pifucillin Amoxicillin-flucloxacillin New Sterilization Amoxicillin-Dichloropicillin Ketal Ampicillin Potassium Herceptin Carbenicillin Sodium Carbenicillin Indoline Benzimidazole penicillin; azlocillin sodium Mezlocillin thiabendazole penicillin Naproxen penicillin Chloramphenicol stearate chloramphenicol stearate Pichiacillin Carbenicillin sodium carbcillin; carbenicillin; carbenicillin sodium; carbenicillin Furicillin potassium furosemide; furicillin; furan benzylpenicillin Sulfenillin sodium sulfoxicillin Cacciation of Carboxythiophene Penicillin Sodium; Thiacillin; Ticarcillin Nitroxanthine penicillin; mecillin hydrochloride Benzathine penicillin G new penicillin; phenyl ethylene diamine penicillin G; phenylhydrazone; bicillin; long-acting penicillin; long-acting thirin; benz Penicillin V Potassium phenoxymethyl penicillin Potassium